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25 June 2019Germ cell tumors (GCTs) are infrequent in childhood, developing at a rate of 2.4 cases per million children and representing approximately 2% to 3% of cancers diagnosed in children and adolescents aged < 15 years [1]. Extracranial GCTs can be categorized as gonadal or extragonadal according to their original sites. GCTs are derived from pluripotent precursor cells known as primordial germ cells, yet they can present as a heterogeneous group of tumors in distinct phenotype [2]. Yolk sac tumors (YSTs), the most common pure malignant GCTs in young children, are confirmed if the precursor cells differentiate to resemble extraembryonic structures. Malignant teratomas (MTs) are teratomas containing at least one of the malignant germ cell elements. YSTs and MTs account